教育演講12:免疫生物製劑在自體免疫疾病治療之進展

E12-4
免疫生物製劑在血清陰性脊椎關節炎與發炎性大腸炎之治療
蔡文展
高雄醫學大學內科

  Spondyloarthropathy defines a group of diseases characterized by chronic inflammation of axial or peripheral joints with a variety of mucocutaneous, ophthalmic lesions. Evidence showed that these disorders are autoimmune in origin with T cells, B cells and monocytes/macrophages playing major roles. In addition, cytokines secreted by these immune cells also were considered indispensible to the triggering of these diseases. Before the era of biological agents, non-steroidal anti-inflammatory drugs (NSAIDS) were only drugs proved to be useful in treating patients with spondyloarthropathy. None of disease-modifying anti-rheumatic drugs (DMARDS) were considered effective in modification of disease course, especially in axial symptom. Thanks to the invention of biological agents, both clinical and radiological parameters were found to improve after targeting therapy. The efficacy of tumor necrosis factor blockage in patients with spondyloarthropathy is almost as effective as in patients with rheumatoid arthritis.

  New insight of pathogenesis uncovered novel molecules involved which were potential targets in the future. The novel therapy include T cell blockage, B cell blockage, and cytokines other than TNF such as IL-6, IL-17, IL-23 are considered potential targets.
In conclusion, new era in the treatment of spondyloarthropathy is coming to the stage. How to broaden their benefits and reduce potential side effects are topics we will face in the near future.